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Approximately 8–15 percent of couples are unable to conceive after 1 year of unprotected intercourse, and they are thereby considered infertile; this problem has become a global health concern, affecting roughly 187 million couples worldwide (). Male factor infertility occurs in 40–50 percent of the infertile couples, being solely responsible in approximately 20 percent of cases and in association with a female factor in another 20–30 percent. Although the male factor infertility is traditionally defined by the presence of abnormal semen parameters, it can nowadays be considered even when the seminal analysis is normal but with abnormal functional sperm tests ().
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